Survey finds strong polarity in doctors'
views on assisted suicide

By Joan Siefert Rose Medical Center
Public Relations

As the national debate continues on the legal and
ethical issues surrounding the assisted suicide of patients by Dr. Jack
Kevorkian, a new survey of Michigan oncologists finds that nearly 21
percent would favor legislation allowing physician-assisted death, and
almost as many acknowledge having participated in such an activity. The
findings are published in the May issue of the Journal of Clinical
Oncology.

David J. Doukas, assistant professor of family practice,
notes, however, that responses to the survey are strongly polarized, with
philosophical attitudes and religious beliefs strongly influencing
individual oncologists' views on active euthanasia and their willingness
to provide the means for a patient's suicide.

"We were not
surprised to find that the majority of doctors specializing in the
treatment of cancer patients would have reservations about acting on
requests to hasten a person's death, even if that option were made legal,"
he says. "What is noteworthy is the extent to which a physician's personal
philosophy affects his response to those requests. This has significant
implications for public policy."

Doukas questioned cancer
specialists because they treat a relatively high percentage of terminally
ill patients and therefore are more likely to directly confront the issue
of assisted suicide.

The survey, measuring both attitudes and
experiences of oncologists toward physician-assisted death, drew responses
from 154 Michigan cancer specialists. Of this group, 18 percent reported
participating in assisted suicide and 4 percent in active euthanasia. By
contrast, more than 80 percent of the respondents acknowledged ending
therapy at a patient's request, a practice that has gained wide medical
and legal acceptance.

Doukas found that oncologists in academic
medical centers were five times more likely than cancer specialists in
community hospitals to support physician-assisted death. Fourteen percent
of the university-based oncologists also said they had given medication
with the intent to cause death, compared to one percent of community-based
oncologists. Possible explanations for the disparity are that doctors in
favor of physician-assisted death may be drawn to academic settings, or
that doctors in academic medical centers may see themselves as somehow
more removed from their patients than doctors in community hospitals,
Doukas says.

In addition, religious beliefs seem to play a role.
Nearly one-half of the doctors indicating no religious affiliation said
they would be willing to provide the means by which a patient could end
his life. By comparison, only 25 percent of Jewish oncologists, 10 percent
of Catholic physicians and 9 percent of Protestant doctors agreed with
that statement. Doukas says the sample groups were small, and the
influence of religion on physician attitudes should be explored
further.

The U-M researcher concludes that even if laws in Michigan
are changed to allow some forms of physician-assisted suicide, patients
may have trouble finding an oncologist willing to carry out their
wishes.